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328例心肌梗死患者的一年随访

[A year follow-up of 328 patients with myocardial infarction].

作者信息

Béard T, Carrié D, Pachins B, Jaillais P, Delay M, Bernadet P

机构信息

Service de cardiologie, hôpital Purpan, Toulouse.

出版信息

Arch Mal Coeur Vaiss. 1994 Jul;87(7):869-73.

PMID:7702429
Abstract

Three hundred and twenty eight patients (238 men, 90 women) with an average age of 63.5 +/- 18 years admitted consecutively for acute myocardial infarction over a 24 month period (March 1989-March 1991) were followed up at one year by out-patient appointment, questionnaire or telephonic enquiry. The average delay before hospital admission was 6.7 +/- 44 hours (1 h-48 h). The infarct was transmural in 82% of cases, anterior in 45.3%, inferior in 46.3% and lateral in 8.4% of cases. Forty eight per cent had one or several complications during the hospital period with a 10.4% hospital mortality rate. Thirty eight per cent of patients underwent primary thrombolysis and 9% had primary angioplasty. Seventy four per cent of patients had coronary angiography; 41% underwent deferred angioplasty and 6% surgical revascularisation. The global 1 year survival rate was 81.4%. At follow-up, 52.6% of patients were asymptomatic, 31% had signs of cardiac failure and 18% had residual angina. Sixty five per cent were treated with 2 or 3 drugs; 6% underwent secondary angioplasty and 2.8% secondary coronary bypass surgery. Of the 34% of active subjects, 61.4% declared having returned to full-time professional activity. Therefore, in 1992, a continuous reduction of infarct-related mortality and morbidity was observed.

摘要

在1989年3月至1991年3月的24个月期间,连续收治了328例急性心肌梗死患者(238例男性,90例女性),平均年龄为63.5±18岁。通过门诊预约、问卷调查或电话询问对这些患者进行了为期一年的随访。入院前的平均延迟时间为6.7±44小时(1小时至48小时)。82%的病例梗死为透壁性,45.3%为前壁梗死,46.3%为下壁梗死,8.4%为侧壁梗死。48%的患者在住院期间出现一种或多种并发症,住院死亡率为10.4%。38%的患者接受了初级溶栓治疗,9%的患者接受了初级血管成形术。74%的患者进行了冠状动脉造影;41%的患者接受了延迟血管成形术,6%的患者接受了手术血运重建。总体1年生存率为81.4%。在随访时,52.6%的患者无症状,31%有心力衰竭体征,18%有残余心绞痛。65%的患者接受2种或3种药物治疗;6%的患者接受了二级血管成形术,2.8%的患者接受了二级冠状动脉搭桥手术。在34%的有活动能力的患者中,61.4%宣称已恢复全职工作。因此,在1992年,观察到梗死相关死亡率和发病率持续下降。

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